According to medical research, gold preparations for the treatment of rheumatic diseases currently occupy the first line in terms of effectiveness among other basic medicines. In most patients, their use helps to achieve significant improvement, in an impressive percentage of cases - stable remission. On average, treatment with gold-based formulations is successful in 80% of patients. Gold compounds have been actively used in medical practice for rheumatic arthritis since 1929
General information
Currently, the exact mechanism by which preparations containing gold affect the human body has not been established. Presumably, these substances accumulate in phagocytes of the mononuclear type. Analyzes revealed an increased concentration of compounds in the synovium of the articular membrane. In these organic tissues, drugs remain for a long time, slowing down the activity of macrophages, neutrophils, as well as the presentation of antibodies to T-helpers. Pathological immune reactions become less active, the generation of rheumatoid factor slows down. The production of prostaglandins responsible for the activation of the inflammatory focus becomes less pronounced.
It has been established that gold s alts are drugs that can slow the progress of rheumatoid arthritis. The most pronounced effect gives a long medication course. The remedy can cause remission, lasting in some cases up to five years. In some situations, drug therapy helps to normalize the structure of bones affected by erosion. Positive progress is accompanied by a weakening of the pain syndrome, ESR returns to normal in the circulatory system. The use of such a group of medicines allows you to abandon non-hormonal anti-inflammatory compounds.
When will it help?
Gold preparations are prescribed for rheumatoid arthritis of the articular form. These drugs (rather toxic to the body) should be resorted to only if a long course of treatment with non-hormonal anti-inflammatory drugs has not shown the desired effect. It will not be possible to do without funds based on gold, if arthritis is prone to rapid progress, it proceeds very aggressively, bone erosion occurs early. The more significant the titers of rheumatoid factor, the more justified the appointment of such drugs in a particular case.
Treatment with gold preparations is practiced if rheumatoid arthritis is confirmed, there is no doubt about the diagnosis and cannot be. Do not start using the remedy in the first six weeksprogress of the disease, as there is a possibility of erroneous definition of pathology. The drug course gives the greatest effectiveness at an early stage of the disease. Persistent contracture, the consequences of arthritis, deformities - all this cannot be corrected with such drugs. In the case of the seronegative type, the group of drugs under consideration is relatively ineffective.
Krizanol
This gold preparation for the treatment of rheumatoid arthritis is based on calcium gluconate, under which a third of the total volume is allocated, and calcium aurothiopropanol sulfonate, which is 70% in the drug. On sale is represented by a five percent suspension in oil. The manufacturer packs the product in ampoules for single use, the volume of one copy is 2 ml. The drug is intended for injection into muscle tissue. One milliliter contains 17 mg of gold.
When planning the use of colloidal gold preparations, however, like any other, it is first necessary to check the body's reaction to the medication course. Assuming the optimal treatment for "Krizanol", you must first put a test injection into the muscle tissue. The patient is injected with a five percent solution in an amount of a milliliter or half as much, after seven days the procedure is repeated. With adequate tolerance, the agent continues to be used once a week, increasing the dosage to the standard 2 ml. The duration of the treatment program is up to eight months.
Continuing therapy
With good tolerability and pronounced efficacy, gold preparation"Krizanol" is used further, making two-week intervals between the administration procedures. For one injection, the patient is given 2 ml of the drug. The duration of this stage reaches four months. With a significant improvement in the condition, a convincing and stable remission, the intervals are increased to three weeks, while maintaining the same dosage.
The total drug course lasts a year, two, sometimes longer, with almost no breaks. This is practiced only if there is a convincing improvement in the patient's condition. The first progress can usually be seen after four months of regular injections of "Krizanol", that is, at the stage when the patient receives a total of 200-400 mg of the main substance. Further signs of improvement should increase.
"Sanokrizin" and "Myokrizin"
Both of these drugs are effective in rheumatoid arthritis. A gold preparation called "Sanokrizin" is used according to a similar program described earlier. Designed for intramuscular injection. A single dosage is 50 mg, of which gold accounts for half the volume.
Under the name "Myocrysin" in pharmacies, a medicine is presented in ampoules for injection. One administration involves the receipt of 20-50 mg of the drug, which contains 10-25 mg of gold. The chemical component that provides the agent with effectiveness is aurothiomalic acid, sodium s alt. To test tolerance, the agent is used in an amount of 20 mg. As part of the main therapeutic course, a single dosage is 50 mg. The drug is intended for injection into muscle tissue.
Auranofin
This remedy is also known under the name "Ridaura". The gold preparation for rheumatoid arthritis is taken orally. A tablet medication is on sale; one copy contains 0.003 g of the active ingredient. For a day, it is shown to use 6 mg, divided into two stages. If the tolerability is satisfactory, the therapeutic course shows a pronounced result, the drug program will be indefinite in duration - sometimes six months, sometimes one and a half, sometimes even more.
Consequences: positive and negative
Liquid gold preparations can provoke quite undesirable and severe side reactions. Approximately every tenth patient against the background of a therapeutic course is faced with inflammatory processes on the oral mucosa, itchy areas covered with rashes appear on the skin. With a frequency of one case for every 10-100 people, hair loss, inflammation of the eye cornea, and a feverish condition occur. The frequency of occurrence of renal disorders is similar - nephrotic syndrome, the presence of protein inclusions in urine.
Liquid gold preparations can cause stool disorders. The likelihood of such a side effect is especially high if Auranofin is selected. On average, 1-10% of patients have aplastic anemia. The use of gold compounds is associated with the likelihood of liver damage, leuko-, thrombocytopenia.
If the patient is prescribed a course of medication based on gold, should be taken regularlysamples of urine, blood for general and biochemical studies. Urgent cancellation requires a condition in which the concentration of protein fractions in urine exceeds 0.2 g / l, erythrocytes - 5-10 g / l. It is important to check the functionality of the liver, analyze the activity of enzymes.
Absolutely not allowed
Gold preparations are not used if rheumatoid arthritis is accompanied by exhaustion, it is accompanied by vasculitis or visceritis. You can not use such funds with a persistent violation of the functionality of the gastrointestinal tract, skin, liver, kidney system. Means do not treat pregnant women, patients suffering from hemocytopenia.
Nuances of therapy
If the use of gold preparations has caused a complication, it is necessary to correct the condition with the use of a five percent solution of unitiol. The drug is injected into muscle tissue, a single dosage is 5 ml. In some cases, the optimal course is Prednisolone. The substance is prescribed for a day in an amount of 15-60 mg. This is more often practiced if taking funds on gold has caused hemocytopenia. In addition, the main course is cancelled.
If a seronegative type of arthritis is diagnosed, a gold tolerance test can be done, but the patient usually responds negatively.
Tauredon
Under this name, a gold preparation is produced that inhibits the generation of lymphocyte antibodies. In addition, the work of plasma cells is controlled. "Tauredon" - the basic option for the correction of autoimmune pathologies. Under its influence, the antigen-inductive activity of lymphocytes slows down, phagocytosis is inhibited,membranes are stabilized, collagen is strengthened. On average, clinical manifestations of improvement can be first noticed at 9-17 weeks of the course, by the time the patient has already received a total of 300-800 mg.
After the injection, the drug of gold in the blood is recorded at a maximum concentration approximately four hours after the injection. Sometimes the indicators are achievable after 3 hours, in other cases it takes twice as long. Increased accumulation of gold is noted in the reticuloendothelial system. Quite a high content is established in the adrenal glands, certain renal tissues. The level of drug accumulation in the bone system and muscle tissues is low.
Kinetics nuances
Shortly after administration, Tauredon reacts with serum albumin and binds almost completely. A day after the injection in the serum, up to 80% of the maximum concentration is observed. 83-90% of the main compound is eliminated by the kidneys, the rest is eliminated through the intestinal tract.
It is possible to achieve an equilibrium concentration with a single dosage of 50 mg in an average of one and a half months. If you use "Tauredon" twice a week, introducing 25 mg of the drug, before the next procedure in the circulatory system, the concentration of the substance is estimated at approximately 3.5 μg / ml.
The half-life is estimated at an average of 27 days.
When and how will it help?
"Tauredon" is prescribed for juvenile rheumatoid, psoriatic arthritis. The preparation of gold is indicated for deep injection into muscle tissue. AtThe procedure requires the use of strictly sterile disposable devices. It is forbidden to heat the medication before administration.
At the moment there is no systematized information about the optimal dosage of Tauredon, there is no information on the basis of which it would be possible to prescribe the remedy. The recommended doses cannot be called standard. In each individual case, you need to choose the format of treatment, focusing on the reaction of the patient's body.
The primary stage is trial, aimed at determining the optimal dosage. It is necessary to assess the level of tolerance, choose the appropriate volumes. First, "Tauredon" is used in a minimum concentration, gradually achieving saturation of the body, after which they practice a maintenance course, due to which a stable level of gold is maintained in the body.
Treatment: adults
At first, Tauredon is used twice a week. The first, second, third injections contain 10 mg of the drug, the next three - twice as much. From the seventh procedure, 50 mg of the drug can be administered twice a week or twice as much once a week. This dosage is maintained until a pronounced clinical effect is observed. It is unacceptable to exceed the maximum allowable amount of the active substance - 1.6 g. If, as this amount is reached, no improvement can be seen, the therapy is canceled.
When observing the effectiveness to maintain the result, "Tauredon" is used once every two weeks in an amount of 50 mg or once a month at twice the concentration. This course lasts for months.years. The duration is determined by the activity of the pathology. As necessary, adjust the dosage, focusing on the patient's condition. Maximum amounts for adults must not be exceeded.
Children: a special occasion
For minors, the doses of Tauredon are selected based on weight. At first, 0.7-1.0 mg of the active substance is prescribed based on each kilogram of mass. When it was possible to achieve an effect, maintenance therapy is practiced, 1-2 times a month by injecting a substance in the amount of a milligram per kilogram.
If the child's weight is less than 20 kg, 5 mg is used once in the first week, then 10 mg is administered from 11 to 24 weeks in a row, after which injections of the drug are given every two weeks in the amount of a milligram per kilogram. If the pathological process gradually fades, the intervals between injections are increased from two to three, then up to four weeks.
At a weight of 20-30 kg, initially 10 mg of the drug is prescribed, then twice as much for a period of 11 to 24 weeks, after which a maintenance dose is administered every two weeks, calculated based on weight.
Risks and dangers
Like other gold preparations, Tauredona can cause skin reactions. The use of the drug is associated with the risk of inflammatory processes in the oral mucosa. Possible dermatitis, some areas of the skin may itch. There is a risk of protein inclusions in the urine. Anemia is possible, leuko-, thrombocytopenia may develop, in some hematopoiesis is lost. Allthese negative effects are quite common (up to 10% of patients report one of the above list).
Revealed that "Tauredon" can in rare cases cause Steven-Johnson syndrome, Lyell and other severe forms of inflammatory and skin reactions. There is a risk of encephalopathy while taking gold products - this is a specific nephritis, accompanied by nephrotic syndrome. There is a risk of pancytopenia, anemia of the aplastic type.
There are isolated cases of inflammation in the bronchi, alveoli during the use of gold preparations. There is a risk of stomach cramps, enterocolitis, pulmonary fibrosis, lichen planus. Possible necrotic processes in the liver cells, immunosuppression, lack of immunoglobulins, neuropathy, violation of the integrity and functionality of the retina, the nervous system of the eye. May lose shade, nails begin to peel off. Such responses to treatment are extremely rare and serve as an indication for urgent withdrawal of the course.
Do I need this?
There are a lot of reviews about gold preparations, since the practice of their use is quite wide. Predominantly, patients who used formulations under the guidance of a doctor noted that the improvement in the condition was significant enough that the negative effects did not interfere with continuing therapy. Self-administration has always led to an undesirable result.
Gold is different
By the way, in pharmacies you can find the drug "Black Gold". It has nothing to do with the means used againstrheumatoid arthritis, and is intended for men who want to increase their sexual activity. The tool contains relatively safe components, however, before using it, you should consult a specialist, since there is a risk of a negative response of the body. To avoid unpleasant surprises, it is recommended to visit your doctor first.
Gold preparations for ceramics are widespread. These are not at all intended for the treatment of people, but are used in industry and arts and crafts. The compositions are designed for the treatment of ceramic surfaces, spectacular and sophisticated decoration of works of art.
